Objective: To investigate correlation between early net fluid balance and the clinical outcomes of patients receiving extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: Adult patients on ECPR admitted to the Department of Emergency in the First Affiliated Hospital of Nanjing Medical University from May 2015 to December 2020 were included. Net fluid balance for consecutive 4 days after ECPR was recorded. The primary outcome was survival to intensive care unit (ICU) discharge. We used multivariable logistic regression to assess the association between fluid status and clinical outcomes.
Results: A total of 72 patients were enrolled and divided into two groups: the survivor group and the non-survivor group. The overall rate of survival to ICU discharge was 44.4%. Daily fluid balance (DFB) in the survivor group was lower than that in the non-survivor group at day 4 (-11.47 (-19.74, 8.7) vs. -5.08 (-12.94, 13.9) mL/kg, P=0.046), as was cumulative fluid balance (CFB) over the first 4 days (-36.03 (-51.45, 19.03) vs. -7.22 (-32.79, 21.02) mL/kg, P=0.009). Both continuous renal replacement therapy (CRRT) and CFB from days 1-4 were significantly correlated with survival to ICU discharge (OR=14.617, 95% CI: 1.344, 48.847, P=0.028; OR=1.261, 95% CI: 1.091, 1.375, P=0.003, respectively). CFB from days 1-4 was determined to have a roughly linear association with the log odds of survival to ICU discharge.
Conclusion: Early negative fluid balance maybe associated with survival to ICU discharge in patients receiving ECPR.
Keywords: Fluid balance; cardiac arrest; critical care; extracorporeal cardiopulmonary resuscitation.
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